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Common use of Form of Conversion Notice Clause in Contracts

Form of Conversion Notice. (To be executed by the Holder in order to convert all or part of that certain $152,500 Fixed Convertible Promissory Note identified as the Note) DATE: ____________________________ FROM: Harbor Gates Capital, LLC Re: $152,500 Fixed Convertible Promissory Note (this “Note”) originally issued by Simplicity Esports and Gaming Company, a Delaware corporation, to Harbor Gates Capital, LLC on April 29, 2020. The undersigned, on behalf of Harbor Gates Capital, LLC, hereby elects to convert $_______________________ of the aggregate outstanding Principal Amount (as defined in the Note) indicated below of this Note into shares of Common Stock, $0.0001 par value per share, of Simplicity Esports and Gaming Company (the “Company”), according to the conditions hereof, as of the date written below. If shares are to be issued in the name of a person other than undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. The undersigned represents as of the date hereof that, after giving effect to the conversion of this Note pursuant to this Conversion Notice, the undersigned will not exceed the “Restricted Ownership Percentage” contained in this Note. Date to Effect Conversion Aggregate Principal Sum of Note Being Converted Aggregate Interest/Fees of Principal Amount Being Converted Remaining Principal Balance Number of Shares of Common Stock to be Issued Applicable Conversion Price Signature Name Address The undersigned, being directors of Simplicity Esports and Gaming Company, a Delaware corporation (the “Company”), acting pursuant to the Bylaws of the Corporation, do hereby consent to, approve and adopt the following preamble and resolutions:

Appears in 1 contract

Samples: Convertible Note (SIMPLICITY ESPORTS & GAMING Co)

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Form of Conversion Notice. (To be executed by the Holder in order to convert all or part of that certain $152,500 Fixed Axxxxxx and Restated Convertible Promissory Note identified as the NoteDue 2005-2008) DATE: ____________________________ FROM: Harbor Gates Capital, LLC Re: $152,500 Fixed Amended and Restated Convertible Promissory Note (this “Note”) originally Due 2005-2008 issued by Simplicity Esports and Gaming Company, a Delaware corporation, to Harbor Gates Capital, LLC on April 29, 2020. ZIX CORPORATION identified below The undersigned, on behalf of Harbor Gates Capital, LLC, undersigned hereby elects to convert $_______________________ of the aggregate outstanding Principal Amount (as defined in the Note) principal amount indicated below of this the Amended and Restated Convertible Note due 2005-2008 into shares of Common Stock, $0.0001 par value per shareof ZIX CORPORATION, of Simplicity Esports and Gaming Company a Texas corporation (the “Company”), according to the conditions hereofterms hereof and of the Note, as of the date written below. If shares are to be issued in the name of a person other than the undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder Holder for any conversion, except for such transfer taxes, if any. The undersigned represents as of the date hereof that, after giving effect to the conversion of this the Note pursuant to this Conversion Notice, the undersigned will not exceed the “Restricted Ownership Percentage” contained in this Section 6(h) of the Note. Conversion information: Note Number Conversion Date to Effect Conversion Aggregate Principal Sum Amount of Note Being Converted Aggregate Interest/Fees Portions of Principal Amount Being Converted Remaining Principal Balance installments of principal to which this conversion is allocated: Due November 2, 2005: $ Due November 2, 2006: $ Due November 2, 2007: $ * Due November 2, 2008: $ * [* Substitute dates of due dates change pursuant to Section 2(d)(2) of the Note] Number of Shares of Common Stock to be Be Issued Applicable Conversion Price Signature Name Address The undersigned, being directors of Simplicity Esports and Gaming Company, a Delaware corporation (the “Company”), acting pursuant to the Bylaws of the Corporation, do hereby consent to, approve and adopt the following preamble and resolutionsBy: TO:

Appears in 1 contract

Samples: Convertible Note Agreement (Zix Corp)

Form of Conversion Notice. (To be executed by the Holder in order to convert all or part of that certain $152,500 550,000 Fixed Convertible Secured Promissory Note identified as the Note) DATE: ____________________________ FROM: Harbor Gates CapitalIconic Holdings, LLC Re: $152,500 550,000 Fixed Convertible Secured Promissory Note (this “Note”) originally issued by Simplicity Esports and Gaming CompanyHealthLynked Corp., a Delaware Nevada corporation, to Harbor Gates CapitalIconic Holdings, LLC on April 29July 11, 20202016. The undersigned, undersigned on behalf of Harbor Gates CapitalIconic Holdings, LLC, hereby elects to convert $_______________________ of the aggregate outstanding Principal Amount Sum (as defined in the Note) indicated below of this Note into shares of Common Stock, $0.0001 par value per share, of Simplicity Esports and Gaming Company (the HealthLynked Corp(the “Company”), according to the conditions hereof, as of the date written below. If shares are to be issued in the name of a person other than undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. The undersigned represents as of the date hereof that, after giving effect to the conversion of this Note pursuant to this Conversion Notice, the undersigned will not exceed the “Restricted Ownership Percentage” contained in this Note. Conversion information: Date to Effect Conversion Aggregate Principal Sum of Note Being Converted Aggregate Interest/Fees of Principal Interest on Amount Being Converted Remaining Principal Balance Number of Shares of Common Stock to be Issued Applicable Conversion Price Signature Name Address The undersigned, being directors of Simplicity Esports and Gaming CompanyHealthLynked Corp., a Delaware Nevada corporation (the “Company”), acting pursuant to the Bylaws of the Corporation, do hereby consent to, approve and adopt the following preamble and resolutions:

Appears in 1 contract

Samples: Convertible Note Agreement (HealthLynked Corp)

Form of Conversion Notice. (To be executed by the Holder in order to convert all or part of that certain $152,500 Fixed 27,500 Convertible Promissory Note identified as the Note) DATE: _______________________________________ FROM: Harbor Gates CapitalTangiers Global, LLC Re: $152,500 Fixed 27,500 Convertible Promissory Note (this “Note) originally issued by Simplicity Esports and Gaming CompanySignal Bay, Inc., a Delaware Colorado corporation, to Harbor Gates CapitalTangiers Global, LLC on April 29March 21, 20202016. The undersigned, undersigned on behalf of Harbor Gates CapitalTangiers Global, LLC, hereby elects to convert $_______________________ of the aggregate outstanding Principal Amount Sum (as defined in the Note) indicated below of this Note into shares of Common Stock, $0.0001 par value per share, of Simplicity Esports and Gaming Company Signal Bay, Inc. (the “Company), according to the conditions hereof, as of the date written below. If shares are to be issued in the name of a person other than undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. The undersigned represents as of the date hereof that, after giving effect to the conversion of this Note pursuant to this Conversion Notice, the undersigned will not exceed the “Restricted Ownership Percentagecontained in this Note. Conversion information: Date to Effect Conversion Aggregate Principal Sum of Note Being Converted Aggregate Interest/Fees of Principal Interest on Amount Being Converted Remaining Principal Balance Number of Shares of Common Stock to be Issued Applicable Conversion Price Signature Name Address The undersigned, being directors of Simplicity Esports and Gaming CompanySignal Bay, Inc., a Delaware Colorado corporation (the “Company), acting pursuant to the Bylaws of the Corporation, do hereby consent to, approve and adopt the following preamble and resolutions:

Appears in 1 contract

Samples: Convertible Note (Evio, Inc.)

Form of Conversion Notice. (To be executed by the Holder in order to convert all or part of that certain $152,500 Fixed 10% Convertible Promissory Note identified as the Note) Note1 DATE: _________________________________ FROM: Harbor Gates CapitalSelkirk Global Holdings, LLC [or current Holder] (the “Holder”) Re: $152,500 Fixed 10% Convertible Promissory Note (this “Note”) originally issued by Simplicity Esports and Gaming CompanyHumble Energy, a Delaware corporation, Inc. to Harbor Gates CapitalSelkirk Global Holdings, LLC on April 29October 2, 20202023. The undersigned, undersigned on behalf of Harbor Gates Capital, LLCthe Holder, hereby elects to convert $_______________________ of the aggregate outstanding Principal Amount (as defined in the Note) indicated below of this Note into shares of Common Stock, $0.0001 par value per share, of Simplicity Esports and Gaming Company (the “Company”), according to the conditions hereof, Stock as of the date written below. If shares are to be issued in the name of a person other than undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder Holder for any conversion, except for such transfer taxes, if any. The undersigned represents as of the date hereof that, after giving effect to the conversion of this Note pursuant to this Conversion Notice, the undersigned Holder will not exceed beneficially own more than 9.99% of the “Restricted Ownership Percentage” contained in this Notetotal outstanding shares of the Company. Date to Effect Conversion Aggregate Principal Sum Amount of Note Being Converted Converted: Aggregate Interest/Fees of Principal Amount Being Converted Converted: Remaining Principal Balance Balance: Number of Shares of Common Stock to be Issued Issued: Applicable Conversion Price Signature Name Address Price: [Holder Company Name] Name: Title: 1 All capitalized terms not herein defined shall have the meaning ascribed to them in the Note. The undersigned, being directors of Simplicity Esports and Gaming CompanyHumble Energy, Inc., a Delaware Florida corporation (the “Company”), acting pursuant to the Bylaws of the Corporation, do hereby consent to, approve and adopt the following preamble and resolutions:

Appears in 1 contract

Samples: Convertible Note Agreement (Humble Energy, Inc./Fl)

Form of Conversion Notice. (To be executed by the Holder in order to convert all or part of that certain $152,500 Fixed 27,500 Convertible Promissory Note identified as the Note) DATE: ____________________________ FROM: Harbor Gates CapitalTangiers Global, LLC Re: $152,500 Fixed 27,500 Convertible Promissory Note (this "Note") originally issued by Simplicity Esports and Gaming CompanySignal Bay, Inc., a Delaware Colorado corporation, to Harbor Gates CapitalTangiers Global, LLC on April 29March 21, 20202016. The undersigned, undersigned on behalf of Harbor Gates CapitalTangiers Global, LLC, hereby elects to convert $_______________________ of the aggregate outstanding Principal Amount Sum (as defined in the Note) indicated below of this Note into shares of Common Stock, $0.0001 par value per share, of Simplicity Esports and Gaming Company Signal Bay, Inc. (the "Company"), according to the conditions hereof, as of the date written below. If shares are to be issued in the name of a person other than undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. The undersigned represents as of the date hereof that, after giving effect to the conversion of this Note pursuant to this Conversion Notice, the undersigned will not exceed the "Restricted Ownership Percentage" contained in this Note. Date to Effect Conversion Aggregate Principal Sum of Note Being Converted Aggregate Interest/Fees of Principal Interest on Amount Being Converted Remaining Principal Balance Number of Shares of Common Stock to be Issued Applicable Conversion Price Signature Name Address The undersigned, being directors of Simplicity Esports and Gaming CompanySignal Bay, Inc., a Delaware Colorado corporation (the "Company"), acting pursuant to the Bylaws of the Corporation, do hereby consent to, approve and adopt the following preamble and resolutions:

Appears in 1 contract

Samples: Convertible Note Agreement (Signal Bay, Inc.)

Form of Conversion Notice. (To be executed by the Holder in order to convert all or part of that certain $152,500 357,500 Fixed Convertible Promissory Note identified as the Note) DATE: ____________________________ FROM: Harbor Gates CapitalIconic Holdings, LLC Re: $152,500 357,500 Fixed Convertible Promissory Note (this “Note”) originally issued by Simplicity Esports and Gaming CompanyHealthLynked Corp., a Delaware Nevada corporation, to Harbor Gates CapitalIconic Holdings, LLC on April 2915, 20202019. The undersigned, on behalf of Harbor Gates CapitalIconic Holdings, LLC, hereby elects to convert $_______________________ of the aggregate outstanding Principal Amount (as defined in the Note) indicated below of this Note into shares of Common Stock, $0.0001 par value per share, of Simplicity Esports and Gaming Company HealthLynked Corp. (the “Company”), according to the conditions hereof, as of the date written below. If shares are to be issued in the name of a person other than undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. The undersigned represents as of the date hereof that, after giving effect to the conversion of this Note pursuant to this Conversion Notice, the undersigned will not exceed the “Restricted Ownership Percentage” contained in this Note. Date to Effect Conversion Aggregate Principal Sum of Note Being Converted Aggregate Interest/Fees of Principal Amount Being Converted Remaining Principal Balance Number of Shares of Common Stock to be Issued Applicable Conversion Price Signature Name Address The undersigned, being directors of Simplicity Esports and Gaming CompanyHealthLynked Corp., a Delaware Nevada corporation (the “Company”), acting pursuant to the Bylaws of the Corporation, do hereby consent to, approve and adopt the following preamble and resolutions:

Appears in 1 contract

Samples: Convertible Note (HealthLynked Corp)

Form of Conversion Notice. (To be executed by the Holder in order to convert all or part of that certain $152,500 Fixed 106,300 Convertible Promissory Note identified as the Note) DATE: ____________________________ FROM: Harbor Gates CapitalTangiers Global, LLC Re: $152,500 Fixed 106,300 Convertible Promissory Note (this “Note”) originally issued by Simplicity Esports and Gaming CompanyBioxytran, Inc., a Delaware Nevada corporation, to Harbor Gates CapitalTangiers Global, LLC on April 29October 23, 20202019. The undersigned, on behalf of Harbor Gates CapitalTangiers Global, LLC, hereby elects to convert $_______________________ of the aggregate outstanding Principal Amount (as defined in the Note) indicated below of this Note into shares of Common Stock, $0.0001 0.001 par value per share, of Simplicity Esports and Gaming Company Bioxytran, Inc. (the “Company”), according to the conditions hereof, as of the date written below. If shares are to be issued in the name of a person other than undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. The undersigned represents as of the date hereof that, after giving effect to the conversion of this Note pursuant to this Conversion Notice, the undersigned will not exceed the “Restricted Ownership Percentage” contained in this Note. Date to Effect Conversion Aggregate Principal Sum of Note Being Converted Aggregate Interest/Fees of Principal Amount Being Converted Remaining Principal Balance Number of Shares of Common Stock to be Issued Applicable Conversion Price Signature Name Address The undersigned, being directors of Simplicity Esports and Gaming CompanyBioxytran, Inc., a Delaware Nevada corporation (the “Company”), acting pursuant to the Bylaws of the Corporation, do hereby consent to, approve and adopt the following preamble and resolutions:

Appears in 1 contract

Samples: Convertible Note (Bioxytran, Inc)

Form of Conversion Notice. (To be executed by the Holder in order to convert all or part of that certain $152,500 50,000 Fixed Convertible Promissory Note identified as the Note) DATE: ____________________________ FROM: Harbor Gates CapitalTangiers Global, LLC (the “Holder”) Re: $152,500 50,000 Fixed Convertible Promissory Note (this “Note”) originally issued by Simplicity Esports and Gaming CompanyIndoor Harvest Corp., a Delaware Texas corporation, to Harbor Gates CapitalTangiers Global, LLC on April 29October 12, 20202017. The undersigned, undersigned on behalf of Harbor Gates CapitalTangiers Global, LLC, hereby elects to convert $_______________________ of the aggregate outstanding Principal Amount (as defined in the Note) indicated below of this Note into shares of Common Stock, $0.0001 0.001 par value per share, of Simplicity Esports and Gaming Company Indoor Harvest Corp. (the “Company”), according to the conditions hereof, as of the date written below. If shares are to be issued in the name of a person other than undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. The undersigned represents as of the date hereof that, after giving effect to the conversion of this Note pursuant to this Conversion Notice, the undersigned will not exceed the “Restricted Ownership Percentage” contained in this Note. Date to Effect Conversion Aggregate Principal Sum of Note Being Converted Aggregate Interest/Fees of Principal Amount Being Converted Remaining Principal Balance Number of Shares of Common Stock to be Issued Applicable Conversion Price Signature Name Address The undersigned, being directors of Simplicity Esports and Gaming CompanyIndoor Harvest Corp., a Delaware Texas corporation (the “Company”), acting pursuant to the Bylaws of the Corporation, do hereby consent to, approve and adopt the following preamble and resolutions:

Appears in 1 contract

Samples: Convertible Note (Indoor Harvest Corp)

Form of Conversion Notice. (To be executed by the Holder in order to convert all or part of that certain $152,500 Fixed 50,000 Convertible Promissory Note identified as the Note) DATE: ____________________________ FROM: Harbor Gates CapitalIconic Holdings, LLC (the “Holder”) Re: $152,500 Fixed 50,000 Convertible Promissory Note (this “Note”) originally issued by Simplicity Esports and Gaming CompanyHigh Performance Beverages Co., a Delaware Nevada corporation, to Harbor Gates CapitalIconic Holdings, LLC on April 29August 16, 20202016. The undersigned, undersigned on behalf of Harbor Gates CapitalIconic Holdings, LLC, hereby elects to convert $_______________________ of the aggregate outstanding Principal Amount (as defined in the Note) indicated below of this Note into shares of Common Stock, $0.0001 0.001 par value per share, of Simplicity Esports and Gaming Company High Performance Beverages Co. (the “Company”), according to the conditions hereof, as of the date written below. If shares are to be issued in the name of a person other than undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder Holder for any conversion, except for such transfer taxes, if any. The undersigned represents as of the date hereof that, after giving effect to the conversion of this Note pursuant to this Conversion Notice, the undersigned will not exceed the “Restricted Ownership Percentage” contained in this Note. Date to Effect Conversion Aggregate Principal Sum of Note Being Converted Aggregate Interest/Fees Interest/ Fee of Principal Amount Being Converted Remaining Principal Balance Number of Shares of Common Stock to be Issued Applicable Conversion Price Signature Name Address The undersigned, being directors of Simplicity Esports and Gaming CompanyHigh Performance Beverages Co., a Delaware Nevada corporation (the “Company”), acting pursuant to the Bylaws of the Corporation, do hereby consent to, approve and adopt the following preamble and resolutions:

Appears in 1 contract

Samples: Convertible Note (High Performance Beverages Co.)

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Form of Conversion Notice. (To be executed by To: Xxxxx & Xxxxx Company The undersigned registered Holder of this Security hereby exercises the Holder in order option to convert all this Security, or part portion hereof (which is $1,000 principal amount or an integral multiple thereof) designated below, for shares of that certain $152,500 Fixed Convertible Promissory Note identified as the Note) DATE: ____________________________ FROM: Harbor Gates Capital, LLC Re: $152,500 Fixed Convertible Promissory Note (this “Note”) originally issued by Simplicity Esports and Gaming Common Stock of Xxxxx & Xxxxx Company, a Delaware corporation, to Harbor Gates Capital, LLC on April 29, 2020. The undersigned, on behalf of Harbor Gates Capital, LLC, hereby elects to convert $_______________________ of in accordance with the aggregate outstanding Principal Amount (as defined in the Note) indicated below terms of this Note into Indenture referred to in this Security, and directs that the shares issuable and deliverable upon such conversion, cash in lieu of Common Stockfractional shares and any portion of this Security representing any unconverted principal amount hereof, $0.0001 par value per share, of Simplicity Esports be issued and Gaming Company (the “Company”), according delivered to the conditions hereof, as of the date written registered Holder hereof unless a different name has been indicated below. If shares or any portion of this Security not converted are to be issued in the name of a person Person other than the undersigned, the undersigned will shall pay all transfer taxes payable with respect thereto and thereto. Any amount required to be paid by the undersigned on account of interest accompanies this Security. The undersigned acknowledges that the conversion of the specified Securities is delivering herewith such certificates and opinions as reasonably requested subject to the requirements established by the Company in accordance therewiththis Indenture, as applicable, as well as the procedures of any Depositary, each as in effect from time to time. No fee In addition, the undersigned certifies that the issuance of shares of Common Stock pursuant to this conversion notice will be charged not cause the undersigned to become, directly or indirectly, a “beneficial owner” (within the holder for any conversion, except for such transfer taxes, if any. The undersigned represents as meaning of Section 13(d) of the date hereof that, after giving Exchange Act and the rules and regulations promulgated thereunder) of more than 14.99% of the shares of Common Stock outstanding at such time. Any purported delivery of shares of Common Stock upon conversion of the Securities shall be void and have no effect to the conversion of this Note pursuant extent (but only to this Conversion Notice, the extent) that such delivery would result in the undersigned will not exceed becoming the “Restricted Ownership Percentage” contained in this Note. Date to Effect Conversion Aggregate Principal Sum beneficial owner of Note Being Converted Aggregate Interest/Fees more than 14.99% of Principal Amount Being Converted Remaining Principal Balance Number of Shares the shares of Common Stock outstanding at such time. If any delivery of shares of Common Stock owed to the undersigned upon conversion of the Securities is not made, in whole or in part, as a result of this limitation, the Company’s obligation to make such delivery shall not be extinguished and the Company shall deliver such shares as promptly as practicable after the undersigned gives notice to the Company that such delivery would not result in it being the beneficial owner of more than 14.99% of the shares of Common Stock outstanding at such time. This notice shall be deemed to be Issued Applicable Conversion Price Signature Name Address The undersigned, being directors of Simplicity Esports and Gaming Company, a Delaware corporation (the “Company”), acting pursuant to the Bylaws an irrevocable exercise of the Corporation, do hereby consent to, approve and adopt the following preamble and resolutions:option to convert this Security. Principal amount to be converted (if less than all): $[ ]

Appears in 1 contract

Samples: Security Agreement (Grubb & Ellis Co)

Form of Conversion Notice. To convert the entire principal amount represented by this Security into shares of Common Stock and Cash in lieu of any fractional shares, and as provided in the Indenture check the box o To convert only part of this Security, state the principal amount to be converted (To which must be executed $1,000 or a multiple of $1,000): If you want the stock certificate made out in another person’s name, fill in the form below: The undersigned (the “Applicant”) hereby makes application for the issuance of record to the name of the Applicant of shares of Common Stock. Dated: Your Signature: (Sign exactly as your name appears on the other side of this Security) Signature Guaranteed Participant in a Recognized Signature Guarantee Medallion Program By: Authorized Signatory U.S. Bank National Association 600 Xxxx 0xx Xxxxxx, 00xx Xxxxx Xxx Xxxxxxx, XX 00000 Attention: Corporate Trust Services (Komag 2.125% Convertible Subordinated Notes due 2014) Re: Komag, Incorporated (the “Company”) 2.125% Convertible Subordinated Notes due 2014 This is a Fundamental Change Purchase Notice as defined in Section 3.01(c) of the Indenture, dated as of March 28, 2007 (the “Indenture”), between the Company and U.S. Bank National Association, as Trustee. Terms used but not defined herein shall have the meanings ascribed to them in the Indenture. Certificate No(s). of Securities: I intend to deliver the following aggregate principal amount of Securities for purchase by the Holder Company pursuant to Section 3.01(a) of the Indenture (in order multiples of $1,000): $ I hereby agree that the Securities shall be purchased on the Fundamental Change Purchase Date pursuant to convert all the terms and conditions specified in paragraph 5 of the Securities and in Article 3 of the Indenture. Print Name of Holder: Signature: (Sign exactly as your name appears on the other side of this Security) Re: 2.125% Convertible Subordinated Notes due 2014 (the “Securities”) of Komag, Incorporated This certificate relates to $ principal amount of Securities owned in (check applicable box): o book-entry or part o definitive form by (the “Transferor”). The Transferor has requested a Registrar or the Trustee to exchange or register the transfer of such Securities. In connection with such request and in respect of each such Security, the Transferor does hereby certify that certain $152,500 Fixed Convertible Promissory Note identified the Transferor is familiar with transfer restrictions relating to the Securities as provided in Section 2.12 of the Indenture, dated as of March 28, 2007, between Komag, Incorporated, as issuer, and U.S. Bank National Association, as trustee (the “Indenture”), and either the transfer of such Security is being made pursuant to an effective registration statement under the Securities Act of 1933, as amended (the “Securities Act”) (check applicable box) or the transfer or exchange, as the Note) DATE: ____________________________ FROM: Harbor Gates Capitalcase may be, LLC Re: $152,500 Fixed Convertible Promissory Note of such Security does not require registration under the Securities Act because (this “Note”) originally issued by Simplicity Esports and Gaming Companycheck applicable box): o Such Security is being transferred pursuant to an effective registration statement under the Securities Act. o Such Security is being acquired for the Transferor’s own account, without transfer. o Such Security is being transferred to the Company or a Delaware corporation, to Harbor Gates Capital, LLC on April 29, 2020. The undersigned, on behalf of Harbor Gates Capital, LLC, hereby elects to convert $_______________________ of the aggregate outstanding Principal Amount Subsidiary (as defined in the NoteIndenture) indicated below of this Note into shares of Common Stock, $0.0001 par value per share, of Simplicity Esports and Gaming Company (the “Company”), according to the conditions hereof, as of the date written belowCompany. If shares are o Such Security is being transferred to be issued in the name of a person other than undersignedthe Transferor reasonably believes is a “qualified institutional buyer” (as defined in Rule 144A or any successor provision thereto (“Rule 144A”) under the Securities Act) to whom notice has been given that the transfer is being made in reliance on such Rule 144A, in reliance on Rule 144A. o Such Security is being transferred pursuant to and in compliance with an exemption from the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by registration requirements under the Company Securities Act in accordance therewithwith Rule 144 (or any successor thereto) (“Rule 144”) under the Securities Act. No fee will be charged o Such Security is being transferred to a non-U.S. Person in an offshore transaction in compliance with Regulation S under the holder for Securities Act (or any conversion, except for such transfer taxes, if any. The undersigned represents as of the date hereof that, after giving effect to the conversion of this Note pursuant to this Conversion Notice, the undersigned will not exceed the “Restricted Ownership Percentage” contained in this Note. Date to Effect Conversion Aggregate Principal Sum of Note Being Converted Aggregate Interest/Fees of Principal Amount Being Converted Remaining Principal Balance Number of Shares of Common Stock to be Issued Applicable Conversion Price Signature Name Address The undersigned, being directors of Simplicity Esports and Gaming Company, a Delaware corporation (the “Company”successor thereto), acting pursuant to the Bylaws of the Corporation, do hereby consent to, approve and adopt the following preamble and resolutions:.

Appears in 1 contract

Samples: Indenture (Komag Inc /De/)

Form of Conversion Notice. (To be executed by the Holder in order to convert all or part of that certain $152,500 550,000 Fixed Convertible Promissory Note identified as the Note) DATE: FROM: ____________________________ FROM: Harbor Gates Capital, LLC (the “Holder”) Re: $152,500 550,000 Fixed Convertible Promissory Note (this “Note”) originally issued by Simplicity Esports and Gaming CompanyBlackboxstocks, Inc., a Delaware Nevada corporation, to Harbor Gates Capital, LLC on April 29May 21, 20202019. The undersigned, undersigned on behalf of Harbor Gates Capital, LLC, hereby elects to convert $_______________________ of the aggregate outstanding Principal Amount (as defined in the Note) indicated below of this Note into shares of Common Stock, $0.0001 0.001 par value per share, of Simplicity Esports and Gaming Company Blackboxstocks, Inc. (the “Company”), according to the conditions hereof, as of the date written below. If shares are to be issued in the name of a person other than undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. The undersigned represents as of the date hereof that, after giving effect to the conversion of this Note pursuant to this Conversion Notice, the undersigned will not exceed the “Restricted Ownership Percentage” contained in this Note. Conversion information: Date to Effect Conversion Aggregate Principal Sum of Note Being Converted Aggregate Interest/Fees of Principal Amount Being Converted Remaining Principal Balance Number of Shares of Common Stock to be Issued Applicable Conversion Price Signature Name Address The undersigned, being directors of Simplicity Esports and Gaming CompanyBlackboxstocks, Inc., a Delaware Nevada corporation (the “Company”), acting pursuant to the Bylaws of the Corporation, do hereby consent to, approve and adopt the following preamble and resolutions:

Appears in 1 contract

Samples: Convertible Note (Blackboxstocks Inc.)

Form of Conversion Notice. (To be executed by the Holder in order to convert all or part of that certain $152,500 Fixed 153,300 Convertible Promissory Note identified as the Note) DATE: ____________________________ FROM: Harbor Gates CapitalTangiers Global, LLC Re: $152,500 Fixed 153,300 Convertible Promissory Note (this “Note”) originally issued by Simplicity Esports and Gaming CompanySignal Bay, Inc., a Delaware Colorado corporation, to Harbor Gates CapitalTangiers Global, LLC on April 29May 19, 20202016. The undersigned, undersigned on behalf of Harbor Gates CapitalTangiers Global, LLC, hereby elects to convert $_______________________ of the aggregate outstanding Principal Amount Sum (as defined in the Note) indicated below of this Note into shares of Common Stock, $0.0001 par value per share, of Simplicity Esports and Gaming Company Signal Bay, Inc. (the “Company”), according to the conditions hereof, as of the date written below. If shares are to be issued in the name of a person other than undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. The undersigned represents as of the date hereof that, after giving effect to the conversion of this Note pursuant to this Conversion Notice, the undersigned will not exceed the “Restricted Ownership Percentage” contained in this Note. Conversion information: Date to Effect Conversion Aggregate Principal Sum of Note Being Converted Aggregate Interest/Fees of Principal Amount Being Converted Remaining Principal Balance Number of Shares of Common Stock to be Issued Applicable Conversion Price Signature Name Address The undersigned, being directors of Simplicity Esports and Gaming CompanySignal Bay, Inc., a Delaware Colorado corporation (the “Company”), acting pursuant to the Bylaws of the Corporation, do hereby consent to, approve and adopt the following preamble and resolutions:

Appears in 1 contract

Samples: Convertible Note (Evio, Inc.)

Form of Conversion Notice. TO: Computershare Trust Company of Canada Corporate Trust Officer - Corporate Trust Department 0000 Xxxxxxxxxx Xxxxxx, Xxxxx 000 Xxxxxxxx, Xxxxxx X0X 0X0 Attention: Xxxxxxxx Xxxxxxx Facsimile No.: (To be executed by 000) 000-0000 Note: All capitalized terms used herein have the Holder meaning ascribed thereto in order the Indenture mentioned below, unless otherwise indicated. Notice is hereby given pursuant to convert all or part section 5.1 of that certain $152,500 Fixed Convertible Promissory Note identified the Indenture dated as of November 13, 2013 (the Note) DATE: ____________________________ FROM: Harbor Gates Capital, LLC Re: $152,500 Fixed Convertible Promissory Note (this NoteIndenture”) originally issued by Simplicity Esports made between the Issuer, the Guarantors and Gaming CompanyComputershare Trust Company of Canada, a Delaware corporationas trustee (the “Trustee”) that the undersigned registered holder of 6% Convertible Unsecured Debentures due November 13, to Harbor Gates Capital, LLC on April 29, 20202020 bearing Certificate No. The undersigned, on behalf of Harbor Gates Capital, LLC, hereby <*> irrevocably elects to convert $_______________________ such Debentures to Common Shares on the date of conversion specified below, in accordance with the terms of the aggregate outstanding Principal Amount (as defined Indenture referred to in such Debenture and tenders herewith the Note) indicated below Debenture, and directs that the Common Shares of this Note into shares of Common Stock, $0.0001 par value per share, of Simplicity Esports the Issuer issuable and Gaming Company (the “Company”), according deliverable upon such conversion be issued and delivered to the conditions hereof, as of the date written Person indicated below. (If shares Common Shares are to be issued in the name of a person Person other than the Holder, all requisite transfer taxes must be tendered by the undersigned.) Dated: (Signature of Registered Holder) Date of conversion: (which date shall fall within a Permitted Conversion Period). * If less than the full principal amount of the Debenture, indicate in the space provided below the principal amount (which must be $1,000 or integral multiples thereof) to be converted. Principal amount to be converted $ (must be $1,000 or integral multiplies thereof) (Print name in which Common Shares are to be issued, delivered and registered) Name (Address, City, Province and Postal Code) Name of guarantor: Authorized signature: Note: If Common Shares are to be issued in the name of a Person other than the Holder, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested signature must be guaranteed by the Company in accordance therewith. No fee will be charged to the holder for any conversion, except for such transfer taxes, if any. The undersigned represents as an authorized officer of the date hereof that, after giving effect to the conversion a Canadian chartered bank or of this Note pursuant to this Conversion Notice, the undersigned will not exceed the “Restricted Ownership Percentage” contained in this Note. Date to Effect Conversion Aggregate Principal Sum a major Canadian trust company or by a medallion signature guarantee from a member of Note Being Converted Aggregate Interest/Fees of Principal Amount Being Converted Remaining Principal Balance Number of Shares of Common Stock to be Issued Applicable Conversion Price Signature Name Address The undersigned, being directors of Simplicity Esports and Gaming Company, a Delaware corporation (the “Company”), acting pursuant to the Bylaws of the Corporation, do hereby consent to, approve and adopt the following preamble and resolutions:recognized medallion signature guarantee program.

Appears in 1 contract

Samples: Indenture (Fairfax Financial Holdings LTD/ Can)

Form of Conversion Notice. (To be executed by the Holder in order to convert all or part of that certain $152,500 Fixed 10% Convertible Promissory Note identified as the Note) Note1 DATE: ______________________________ FROM: Harbor Gates CapitalAmiba Energy, LLC [or current Holder] (the “Holder”) Re: $152,500 Fixed 10% Convertible Promissory Note (this “Note”) originally issued by Simplicity Esports and Gaming CompanyHumble Energy, a Delaware corporation, Inc. to Harbor Gates CapitalAmiba Energy, LLC on April 29July 30, 2020. 2024 The undersigned, undersigned on behalf of Harbor Gates Capital, LLCthe Holder, hereby elects to convert $_______________________ of the aggregate outstanding Principal Amount (as defined in the Note) indicated below of this Note into shares of Common Stock, $0.0001 par value per share, of Simplicity Esports and Gaming Company (the “Company”), according to the conditions hereof, Stock as of the date written below. If shares are to be issued in the name of a person other than undersigned, the undersigned will pay all transfer taxes payable with respect thereto and is delivering herewith such certificates and opinions as reasonably requested by the Company in accordance therewith. No fee will be charged to the holder Holder for any conversion, except for such transfer taxes, if any. The undersigned represents as of the date hereof that, after giving effect to the conversion of this Note pursuant to this Conversion Notice, the undersigned Holder will not exceed beneficially own more than 9.99% of the “Restricted Ownership Percentage” contained in this Notetotal outstanding shares of the Company. Date to Effect Conversion Aggregate Principal Sum Amount of Note Being Converted Converted: Aggregate Interest/Fees of Principal Amount Being Converted Converted: Remaining Principal Balance Balance: Number of Shares of Common Stock to be Issued Issued: Applicable Conversion Price Signature Name Address Price: [Holder Company Name] Name: Title: 1 All capitalized terms not herein defined shall have the meaning ascribed to them in the Note. The undersigned, being directors of Simplicity Esports and Gaming CompanyHumble Energy, Inc., a Delaware Florida corporation (the “Company”), acting pursuant to the Bylaws of the Corporation, do hereby consent to, approve and adopt the following preamble and resolutions:

Appears in 1 contract

Samples: Convertible Note (Humble Energy, Inc./Fl)

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